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APPLICATION CONSTRUCTION INFORMATION
FOR: Certificate of Zoning Compliance ❑ To CITY of ARLINGTON CLASS of WORK (check) NEW ALTERATION ❑ , ADDITION ❑ , DEMOLISH ❑.
Building Department
Building Permit Describe Alteration c� {Iah,
Certificate of Occupancy ❑ Date
NOTICE: No permit for erection, alteration, moving, repair or occupancy of any building
shall be issued until an application has been made and approved for a certifi- Valuation based on total floor�rea $ N O T I C E
cate of zoning compliance.
Where work is started
1 `` Plan checking fee yJ $ before permit is obtained
Owner n O QQ la (1 Ll.L r- '�f S. �L �tp/C the permit fee shall
��,<_1a Y1 K�Y1,Q.F� Address Permit fee $ .��L �L
1" be doubled.
Permittee Address
Architect Address_
SPECIFICATIONS
Engineer Address
FOUNDATIO_ N_ _ Exterior Piers COVERING
contractor Address Material Exterior walls
LEGAL DESCRIPTION OF PROPERTY: Lot No. 12 IX l9-� L)-'J Block No.__ Width at top Interior walls
Subdivision or Unplatted description rJ�ur �, �� Ak�/ti✓di'`d"I L3'?If'g
Width at bottom Roof or reroofing
Depth in ground
I
ZONING INFORMATION FRAME Size Spacing Span FLUES
TY*-;OF OCCUPANCY of present or TYPE of CONSTRUCTION of present or R.W. Plate(sill) Fireplace
proposed main building (circle) proposed main building (circle) Girders Floor furnace
A B C .Q,aE F G H I J I II III III 1 hr. III HT Joist, Istfloor Kitchen
DIVISION ---1— 2 3 4 IV IV 1 hr. V V 1 hr. Joist,2nd floor Water heater
Joist,ceiling Furnace
ti Use Zone Fire Zone Area-of Lot
Size of building or addition No.of stories Exterior studs Gas Oil
Total height Basement floor area 1st Floor area
Interior studs
Additional floors and areas
No.of rooms No.of families Roof rafters
No.of buildings now on lot Use of buildings now on lot
Bearing walls
Percentage of lot covered by main building Additional Permits are required for:
Percentage of lot covered by accessory buildings (check) IMPORTANT
Kind of livestock g, g ❑ Moving,❑ Plumbing, ❑ Signs, Written authorization of owner must
CHANGE OF OCCUPANCY from to ❑ Sewer hookup, ❑ Water hookup, be presented when applicant is occupant
If a commercial building,list each use and its area in square feet: ❑ Gas appliance and Gas piping. or lessor. I am the legal owner of the
� I hereby acknowledge that I have read this application and property described in this application.
state that the above is correct and agree to comply with all
city ordinances an ate Laws regula ' g zoning and building
Owner
DRAW on the reverse side of this application, to scale, a PLOT PLAN. APPLICAN
PLOT PLAN FOR DEPARTMENTAL USE
FOR DEPARTMENTAL USE Application for Certificate of Zoning ❑
Draw below,to scale, a plot plan showing: � pp � in Compliance
g C liance p
Checked Initials
1. Dimension and shape of the lot. 1.
2. Front street name. 2. Building Permit ❑, Certificate of Occupancy ❑ checked and approved.
3. Side street name if corner lot. 3.
4. Sizes and location on the lot of buildings already existing. 4.
5. Location and dimensions of proposed building or alterations. 5. Building Inspector /�==+- t� Date
6. Front yard,side yard,rear yard setbacks. 6.
7. Locate and describe any fences,walls,hedges,signs, 7. Q Date
Issued Building Permit No.
front yard trees and shrubs,green belt.
8. Location and size of required off-street parking and loading. 8.
INSPECTION RECORD
Inspection Date Signature
Set Back
Excavation
Concrete
r Reinforced Steel
Grout Blocks f f
Bond Beam .1
Frame
Roofing
Room Ventilation I rj
Kitchen Vent I t
Bathroom Vent
Foundation Vent
Access Hole
Garage Fireproofing
Fireplace
Spark Arrester
Water Closet
Water Heater
Sewage Disposal
Lathing
Plastering
Correction Order Left
Stop Work Order Issued
Stop Work Order Released
Give brief report of special or unusual conditions
i 4 /'
Job completed Date 4
Building Inspector
Certificate of Zoning Compliance No. Issued
Date
Certificate of Occupancy No. Issued
Date
MOORE BUSINESS FORMS INC LA